Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2091TG | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2091T | TX |
N | 152WP0200X | Pediatric Optomitrist | 2091T | TX |
N | 152WS0006X | Sports Vision | 2091T | TX |
NPI | 1366424517 |
---|---|
Provider Name | Dr. George Louis Hall JR. |
First Address | Houston, TX 77058-4500 |
Second Address | Houston, TX 77058-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 13/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148276204 | (05) | TX |
T13633 | (02) | TX |